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Mechanism of action

Hypotensive, antianginal, antiarrhythmic, vasodilator. Blocks Calcium channels.

Quickly and completely (90-92%) absorbed in the small intestine. Almost all metabolized. T1/2 after a single dose is from 3 to 7 h (with multiple - increases by 2 times). Excreted mainly by the kidneys (intestine - about 16%). It passes the placental barrier, penetrates into breast milk (in small quantities).

Indications and usage

Hypertension (mild, moderate and severe).

Inside, without chewing, during or after food, washing down with a small amount of liquid, 240-360 mg (the dose is selected individually). With long-term therapy, the daily dose should not exceed 480 mg. Usually prescribed in the morning for 240 mg. If a slow decrease in blood pressure is desired, 120 mg is prescribed.

Adverse reactions

Sinus bradycardia, sinoatrial block, asystole, AV block, bradycardia, hypotension; heart failure, dizziness, headache, weakness, lethargy, irritability, paresthesia, nausea, constipation, edema, arthralgia, myalgia, flushes, allergic reactions.


Cardiogenic shock, acute complicated myocardial infarction (with symptoms of bradycardia, hypotension, left ventricular failure),AV block II-III degree, sinoatrial blockade, sick sinus syndrome.

Pregnancy and breastfeeding

With care (especially in the first trimester).

Special notes

With caution prescribed for AV blockade I degree (bradycardia less than 50 beats per minute), hypotension, (MAP below 90 mm Hg), flicker, atrial flutter with the simultaneous presence of ventricular premature arousal syndrome, heart failure condition, such as cardiac glycosides). It should not be combined with a / in the introduction of beta-blockers.


Symptoms: hypotension, shock, loss of consciousness, AV block I and II degree, complete AV block, AV rhythm with loss of the sinus node function, asystole, sinus bradycardia, sinoatrial blockade.
Treatment: gastric lavage, induction of vomiting, suction of the contents of the stomach and intestines under endoscopic control, cleansing enemas. As a specific antidote - in / in 10-20 ml of 10% solution of Calcium gluconate, if necessary, repeat or carry out additional drip infusion (5 mmol / h).

Drug Interactions

Enhances the effects of beta-blockers, inhaled anesthetics, antiarrhythmics, muscle relaxants. Potentiates the hypotensive effect of other antihypertensive agents, the neurotoxic effect of Carbamazepine and lithium preparations. Plasma levels are reduced by rifampicin, phenytoin and phenobarbital. Increases cimetidine.

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